Provider Demographics
NPI:1831125392
Name:L&T INJURY & WELLNESS L.L.C.
Entity Type:Organization
Organization Name:L&T INJURY & WELLNESS L.L.C.
Other - Org Name:ALIGN REHAB & WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINCOLN
Authorized Official - Middle Name:O
Authorized Official - Last Name:CLIFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-235-9944
Mailing Address - Street 1:2230 N UNIVERSITY PKWY
Mailing Address - Street 2:6B
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-1509
Mailing Address - Country:US
Mailing Address - Phone:801-235-9944
Mailing Address - Fax:801-235-9955
Practice Address - Street 1:2230 N UNIVERSITY PKWY
Practice Address - Street 2:6B
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-1509
Practice Address - Country:US
Practice Address - Phone:801-235-9944
Practice Address - Fax:801-235-9955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT275117-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1730187675OtherNPI
UT000059315Medicare PIN
UT000059314Medicare PIN
UTU72103Medicare UPIN